A09 Enhancing field trauma care capability by support from uncrewed aerial systems: a multidisciplinary analysis of logistics and telementoring requirements

Background The ongoing war in Ukraine has witnessed a major proliferation in the application of uncrewed aerial systems (UAS) for military purposes, including some medical applications. The present project examines the possibility of using UAS to increase the capability of first-line trauma caregivers in military settings that demand prolonged pre-hospital care. This is especially relevant in war zones akin to the Ukrainian front, where the absence of air supremacy has led to loss of rapid aerial medevac/casevac capability. 1 This in turn has resulted in a demand for a more advanced care under forward-deployed field conditions. As personnel with advanced training in trauma care are scarce resources in most armed services, this demand is hard to meet under current frameworks of military medical doctrine. 2 The present project seeks to circumvent the issue of reduced casevac/medevac capability and scarcity of frontline medical personnel by UAS-based solutions that increase the capability of frontline caregivers by delivering (1) medical supplies, (2) field-forward telementoring capacity and (3) mapping the most rapid way in and out for ground-based evacuation. Methods Successful integration of drone technology in advanced healthcare is not only a medical or technical issue, but also requires logistical, geographical, organizational, as well as management and collaboration perspectives. 3 As the start of the project in 2025, three empirical studies are planned: An interview study with frontline caregivers to map challenges for the effective use of drones and how they could be overcome. In this step, proposals are made for different repertoires of equipment (trauma kits) and products for delivery across a typical set of casualty scenarios. Analysis using geographic information systems (GIS) of the probability that blood can be delivered to wounded soldiers within 30 minutes by UAS instead of ground transport under different scenarios of road navigability, type of drone, level of telecommunications interference, weather, and base setup. Start-up of case-control studies during military exercises with different scenarios where critical parameters for healthcare logistics are compared across different approaches for UAS support, such as the use of UAS compared ground transport and different types of UAS-delivered trauma kits. Results The project was initiated in 2025 with the formation of a multidisciplinary team. Studies are in a planning phase in collaboration with the Swedish Armed Forces. Electronic warfare has been identified as a major challenge to telementoring solutions in need of robust technical solutions. Swarm tactics to combine delivery of equipment and high-resolution 3D mapping of battlefield geography have been conceptually explored as solutions to drone pilot scarcity and limited ground-medevac access, respectively (figure 1). Conclusion UAS support to frontline caregivers could potentially have a high impact on survival and saving of limbs from amputation. However, to reach its full potential it needs to be integrated in current doctrine and embrace emerging technologies in swarming and telementoring using augmented reality equipment. References Jarrassier A, Py N, de Rocquigny G, et al . Lessons learned from the war in Ukraine for the anesthesiologist and intensivist: A scoping review. Anaesth Crit Care Pain Med 2024; 43 (5):101409. doi: 10.1016/j.accpm.2024.101409 [published Online First: 20240730] Bongartz LG, Quinn VJ, Fransen CM, et al . A Call for comprehensive reform of military medical planning of NATO and its allies based on lessons from the Ukraine war-cultural context and the human factor. Mil Med. 2025 doi: 10.1093/milmed/usaf217 [published Online First: 20250603] Roberts NB, Ager E, Leith T, et al . Current summary of the evidence in drone-based emergency medical services care. Resusc Plus . 2023; 13 :100347. doi: 10.1016/j.resplu.2022.100347 [published Online First: 20230106] Conflict of interest statement The authors have no relevant conflicts of interest to declare. The study is funded by a Lund University seeding grant from the Office of the Vice Chancellor. Abstract A09 Figure 1 The medical swarm concept. The present study explores the concept of a medical assistance swarm for tackling the medical challenges of the so-called ‘transparent’ battlefield. Here, a lack of safe aerial medevac/casevac possibilities results in accumulation of wounded under forward tactical field care conditions. To alleviate this, we suggest using a swarm of drones solving multiple tasks, including laying down ad-hoc network nodes for communications in tele-denied environments (1–2), delivering medical products needed to enhance trauma care concomitant to telementoring equipment (3A) – together enhancing the capability of combat medics at the frontline. Swarm members will at the same time map the terrain of the battlefield (3B) to find the best way in and out for ground transport, thus preparing for ground evacuation of stable wounded at a favorable timepoint (4)